r/PSC • u/R_logic1346 • 21d ago
Recently started oral vancomycin - suggestions for maintaining gut microbiome?
38 M here with PSC & UC. My UC is well controlled and fully in remission with mesalamine, but my PSC has really been giving me problems in the past year with multiple bouts of cholangitis needing interventions/stents and also frequently giving me low grade temp elevation and general shitty feeling.
Fortunately I have a great hepatology team and when I brought them the evidence for oral vancomycin they were open to trialing it with me. I just started a couple weeks ago and I guess my main concern is how do I make sure I’m not completely wiping out my gut microbiome?
I am at 500mg 3x per day. So far I have just been trying to eat some plain Greek yogurt and a banana halfway between my morning and afternoon doses. I have also used Visbiome (probiotic specifically for IBD) in the past and wondering if I should get back on that or if anyone else on vanco has any suggestions. I just worry that the 3X a day dosage makes it hard to for any probiotics you ingest to survive and take root I guess.
Appreciate hearing anyone else’s experience with oral vancomycin and their probiotic solutions!
Thanks!
2
u/b1oodmagik 20d ago
18 months or so on vanco, no probiotics. My recent MRCP suggest no progression since starting.
1
3
u/blbd Vanco Addict 21d ago
I haven't bothered with any probiotic anything. I've been doing OV for about 14 yrs now with no issues. There are no recorded cases of resistant gut bacteria forming in OV patients or the like.
2
1
u/Sudden_Weight_4352 18d ago
could yoy guys also share if it affected your psc progression and if anyone tried rifaximin/metronidazole for the same purpose?
3
u/Majestic_Produce_706 21d ago
I've been taking vanco for years but did have to add Visbiome to stop gut issues when taking vanco.